Cardiogenic shock

Choc Cardiogénique

Cardiogenic shockCLINICAL SIGNS:

* sweating , pallor , cold extremities, mottling especially at the knees, recolouring time elongated> 3 seconds.

* drop in blood pressure (<80 mmHg), pinch differential.

* fast and fast pulse.

* cyanosis, polypnea.

* disturbances of consciousness: agitation, drowsiness, prostration.

* oligo-anuria.

* signs of the cause.

* progression to respiratory distress, obstruction and coma, convulsions and cardiorespiratory arrest.


* hypovolemic shock secondary to haemorrhage, burns, heat stroke, limb crushing, haemolysis (malaria, transfusion accident, Clostridium sepsis).

* anaphylactic shock due to abnormal vasodilation.

* septic shock.


* myocardial infarction , PAO , impaired left ventricular rhythm disorder, prosthetic valve dysfunction, infective endocarditis, tamponade, pulmonary embolism , aortic dissection.

* drug poisoning (carbamates, beta-blockers, tricyclics, calcium channel blockers, colchicine).

* acute pancreatitis, thyrotoxicosis, shoshin, Béri-Béri.


* scope, SpO²: unreliable if persistent shock.

* ECG with V3R, V4R.

* in a second time:

– pulmonary radiography.

– blood gas, blood and urinary ionogram, creatinine, NFS, CPK, blood glucose, TP, TCA, platelets, blood group.

– echocardiography.


* patient lying down, raised legs, warmed up.

* oxygen therapy with the mask 8-10 l / mn.

* venous veins of large caliber.

* colloids (except anaphylactic shock), macromolecules if hypovolemia.

* Dobutrex : 10-15 μg / kg / min or Dopamine: 3-10 μg / kg / min with an electric syringe.

– if failure: Levophed, 0.2-1 μg / kg / min with the electric syringe.

* treatment of the cause.

* intubation and assisted ventilation if vital distress after possible sedation (Hypnovel + Fentanyl).